XYK-23046-82378
5 vaccinations
3 coded responses
68 check-ins
3 free-text entries
0 call cases
- Sex
- Male
- Age at first dose
- 66+
- ZIP prefix
- 606 / IL
- Registered
- 2021-01-27
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-27
Registered in v-safe
-
2021-01-27
Dose 1 — Moderna
- 2021-01-27
- 2021-01-28
- 2021-01-29
- 2021-01-30
- 2021-01-31
- 2021-02-01
- 2021-02-02
- 2021-02-03
- 2021-02-10
- 2021-02-17
-
2021-02-24
Dose 2 — Moderna
- 2021-02-24
-
2021-02-25
Health check-in — days 1–6 daily, dose 2Feeling: Poor · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activitiesAdult check-in
-
2021-02-26
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Fatigue or tiredness · Be unable to workAdult check-in
- 2021-02-27
- 2021-02-28
- 2021-03-01
- 2021-03-02
- 2021-03-03
- 2021-03-10
-
2021-03-17
Survey response — 21 day, dose 2MedDRA: Back pain, Pain, Pain in extremity — Feeling: Fair · Be unable to do your normal daily activitiesMedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
- 2021-03-24
- 2021-03-31
- 2021-04-07
- 2021-05-26
- 2021-08-25
-
2021-12-29
Dose 3 — Moderna
- 2021-12-29
-
2021-12-30
Survey response — days 1–6 daily, dose 3MedDRA: Heart rate increased, Vaccine positive rechallenge — Feeling: Fair · Fever · HeadacheMedDRA releases: 2024-11 · check-in answers available
- 2021-12-31
- 2022-01-01
- 2022-01-02
- 2022-01-03
- 2022-01-04
- 2022-01-05
- 2022-01-12
- 2022-01-19
- 2022-01-26
- 2022-02-02
- 2022-02-09
- 2022-03-30
- 2022-06-29
-
2022-07-29
Dose 4 — Moderna
- 2022-07-29
-
2022-07-30
Survey response — days 1–6 daily, dose 4MedDRA: Heart rate increased — Feeling: Fair · Site: Pain, Redness · Fever · HeadacheMedDRA releases: 2024-11 · check-in answers available
-
2022-07-31
Health check-in — days 1–6 daily, dose 4Feeling: Good · Site: Pain, Redness, Swelling · Rash, not including the immediate area around the injection siteAdult check-in
- 2022-08-01
- 2022-08-02
- 2022-08-03
- 2022-08-04
- 2022-08-05
- 2022-08-12
- 2022-08-19
- 2022-08-26
- 2022-09-02
- 2022-09-09
-
2022-10-11
Dose 5 — Moderna
- 2022-10-11
- 2022-10-12
- 2022-10-13
- 2022-10-14
- 2022-10-15
- 2022-10-16
- 2022-10-17
- 2022-10-18
- 2022-10-25
- 2022-11-01
- 2022-11-08
- 2022-11-15
- 2022-11-22
- 2023-01-10
- 2023-04-11
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-27 | Moderna | |
| 2 | 2021-02-24 | Moderna | |
| 3 | 2021-12-29 | Moderna | No |
| 4 | 2022-07-29 | Moderna | No |
| 5 | 2022-10-11 | Moderna | No |
Free text
Release 5
Symptoms: I have been experiencing back pain that extends into my left arm today. I am reporting it because that is the arm in which I received both shots (Moderna), but I don't think the pain is vaccine related.
Release 10
Systemic reaction (other): Pulse rate was up this morning, as it was after the first and second shots -- not alarming, but it was something I noticed and thought I should report.
Release 12
Systemic reaction (other): pulse rate was high this morning, as it was after the first booster
Free-text releases are not linked to a specific survey response. The CDC cut some text off at about 250 characters: symptoms in every release, and the other two fields in releases 9-12. Those entries are marked "cut off by CDC".
MedDRA terms by release
| Field | Preferred term | 2021-09 | 2023-04 | 2024-11 |
|---|---|---|---|---|
| SD | Back pain | ✓ | ✓ | ✓ |
| SD | Pain | · | · | ✓ |
| SD | Pain in extremity | ✓ | ✓ | ✓ |
| SRO | Heart rate increased | · | · | ✓ |
| SRO | Vaccine positive rechallenge | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release